Factors affecting the use of influenza vaccine in the institutionalized elderly.

Annual influenza vaccination has been recommended for the past four years for all the patients residing on the extended-care facility of this large county hospital. During the fall of 1983, baseline data was collected regarding compliance with these recommendations. It was found that only 33% of the high-risk individuals had been vaccinated. A study was planned to investigate the factors for poor compliance rate and explore alternate methods of delivery of the vaccine. Despite the physician's strong belief in the vaccine, all methods of reminders to the physicians failed to have significant impact on increased use of the influenza vaccine. Finally an institutional policy pertaining to a standing order for the influenza vaccine was approved by the Infection Control Committee and the hospital Medical Staff Committee and 95% of the patients on the extended-care facility of this hospital were immunized.